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Chronic vomiting with abdominal pain in upper left quadrant
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Chronic vomiting with abdominal pain in upper left quadrant


     My wife has had an ongoing problem for the last 6 weeks involving severe pain in the upper left quadrant of her abdomen and vomiting after every meal.  The vomiting happens within 5 minutes of eating and occurs even with medicine used to stop this.  She was hospitalized for 8 days and had a variety of tests run MRI, Ultrasounds, CT scans, Hida scan, endoscopy and colonoscopy, bloodwork and urine samples...all were negative.
Though she did show a hiatal hernia during the endoscopy.  Some of these tests were performed after leaving the hospital.  No reason could be found and it was diagnosed as IBS.  She was released from the hospital still in pain and still vomiting though at this point she could hold down fluid food.  When she got home we tried soy food, gluton free food, and fluid food.  Nothing worked and it got worse..She was no longer able to keep fluid food down either.  After seeing the doctor a few more times and being put on a variety of anti nausea medicines and pain medicines nothing has worked.  The doctors believe that it is all stress/mental related.  Nothing in our recent life has been stressful..she moved to a less stressful job in a better store (She works night shift as a cake decorator). We recently moved a month before this happened to a place we like more kids are great our relationship is great and our money situation has improved.  So to us it doesnt seem a realistic diagnosis.  She did agree to see a psychiatrist to rule this out.  This will happen in the near future.  Is there anything else we can look at?  
  She was admitted again to the hospital 2 days ago for urine retention..She has been unable to urinate for 3 days..Her first visit to the emergency room drained 1200cc and the second 700cc.  This happened after a sever vomiting episode during which she felt a pop in her left side.  She immediately had pain in her side left and right but more pronounced on her left and from that time forth could no longer urinate.
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Hello - thanks for asking your question.

You note left upper quadrant pain and vomiting after every meal.  MRI, ultrasounds, CT scans, hida scan, endoscopy and colonoscopy, bloodwork and urine samples all were negative.  There is also urine retention.  

You have obviously had a very comprehensive workup with many tests coming up negative.  One last consideration would be a gastric emptying scan to evaluate for gastroparesis.  Gastroparesis (or delayed gastric emptying) can be seen in association with many diseases including scleroderma, diabetes, and a variety of neurologic disorders.  If this has not been performed, I would recommend it.  

Regarding the urinary retention, this needs to be evaluated by a urologist.  Tests such an IVP, cystoscopy  or urodynamic studies should all be considered to determine the cause.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
3 Comments
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Avatar_n_tn
I am so sorry about your wife. If the doctor you had thinks this is all in her head-maybe you should consider taking her to another hospital and doctor. She should not have to go on like that and be told she needs to see a psychiatrist.  Good luck to you both.
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Avatar_n_tn
I agree with the doctor, it sounds very much like gastroparesis. It is a baffling illness, and can occur for a number of reasons. Often, no direct cause is identified. Your experience is not unusual either, many other diagnoses are made, often in error. There are medications for this disorder. There is also a support group for gastroparesis on Yahoo that is very good. Hopefully they will be able to find the answers and get her the help she so desperately needs.
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Avatar_n_tn
I'm sorry to hear your wife is sick.  But I know what she is going through. I've been vomiting, with right side pain and diarrhea, for over three weeks. I had a CT scan done and every thing came back negative. And here I am still suffering. My doctor doesn't know what is causing this. I haven't been able with out everything coming back up. It has gotten worse the last week I can't even try to eat just looking at the food I can feel the vomit rising in my throat.  So if anyone has any suggestions they will be greatly appreciated.
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